Please complete the following questions. When you are finished, click the "SUBMIT" button at the bottom of the page. Your information will be promptly reviewed by a Rent-Right representative. You should receive a follow-up e-mail or phone call within 2 days of submitting.

Thank You for choosing Rent-Right !

(Part 1) Applicant Information (required)

Full Name:

Date of Birth: (mm/dd/yyyy)

E-mail:

SIN:

Treaty no:

Current Address:

Rent
Own
Other

Landlord / Mortgage Company
(Name, Address, and Phone)

Rent / Mortgage Payment:

$ /mnth

Previous Address:
(If less than 1 year at Current Address)

Home Phone:

(902)

Cell Phone:

(902)

Current Employer
(Name and Address)

Work Phone:

(902)

Position

How Long?

years

Income:

$ /pay

Please List any other amounts /sources of income:

Pay-Day Frequency:

Every Week

Every 2nd Week

15th and 30th

Every Month

Previous Employer
(if less than 1 year with Current Employer)

(Part 2) Co-Applicant Information (optional)
Full Name:			Date of Birth: (mm/dd/yyyy)
E-mail:			SIN:
			Treaty no:

Current Address:			Rent Own Other
Landlord / Mortgage Company (Name, Address, and Phone)			Rent / Mortgage Payment:	$ /mnth
Previous Address: (If less than 1 year at Current Address)			Home Phone:	(902)
			Cell Phone:	(902)

Current Employer (Name and Address)			Work Phone:	(902)
Position	How Long?	years	Income:	$ / year
Previous Employer (if less than 1 year with Current Employer)

(Part 3) References (required)
1.	Name:	Phone:	(902)
	Address:	Relationship:

2.	Name:	Phone:	(902)
	Address:	Relationship:

3.	Name:	Phone:	(902)
	Address:	Relationship:

How did you hear about Rent Right? (optional)
Flyer / Direct Mail	Repeat Customer	Radio
Yellow Pages	TV	Friend / Family Member
Other (please explain)
Have you or are you currently leasing from another lease company?	Yes No

Release of Information

By clicking the "SUBMIT" button below, your are confirming that you have read, understand, and agree to the following:
1. the information you (the applicant) have provided on this form is correct and that you authorize complete verification of all information as you have provided.
2. for verification and/or collection purposes, we (Rent Right) may contact any person or company listed above and you release all parties from any liability that may result.
3. for verification and/or collection purposes, you voluntarily waive the protection of all rights to privacy laws.
4. this application may be rejected if any information provided is found to be false.

You MUST complete this "CAPTCHA" verification before you click "SUBMIT" at the bottom of the page.

(Part 1) Applicant Information (required)

(Part 2) Co-Applicant Information (optional)

(Part 3) References (required)

How did you hear about Rent Right? (optional)

Release of Information